Bothell Foot & Ankle Clinic Pllc | |
18525 101st Ave Ne Ste 3 Bothell WA 98011-3452 | |
(425) 806-1943 | |
(425) 402-3900 |
Full Name | Bothell Foot & Ankle Clinic Pllc |
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Speciality | Clinic/Center |
Location | 18525 101st Ave Ne Ste 3, Bothell, Washington |
Authorized Official Name and Position | Shi-yuan Cheng (OWNER) |
Authorized Official Contact | 4258061943 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bothell Foot & Ankle Clinic Pllc 18525 101st Ave Ne Ste 3 Bothell WA 98011-3452 Ph: (425) 806-1943 | Bothell Foot & Ankle Clinic Pllc 18525 101st Ave Ne Ste 3 Bothell WA 98011-3452 Ph: (425) 806-1943 |
NPI Number | 1437362977 |
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Provider Enumeration Date | 05/08/2007 |
Last Update Date | 05/10/2011 |
Medicare PECOS PAC ID | 8921095704 |
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Medicare Enrollment ID | O20040426001488 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437362977 | NPI | - | NPPES |
8801780 | Other | WA | GROUP PIN |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Shi Yuan Cheng |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1790729283 PECOS PAC ID: 6002710605 Enrollment ID: I20031125000406 |
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